Provider Demographics
NPI:1902071590
Name:SOUTHWEST HEART AND VASCULAR CARE, LTD.
Entity type:Organization
Organization Name:SOUTHWEST HEART AND VASCULAR CARE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:VILLANUEVA
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-344-8400
Mailing Address - Street 1:789 W 27TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7207
Mailing Address - Country:US
Mailing Address - Phone:928-344-8400
Mailing Address - Fax:928-344-8412
Practice Address - Street 1:789 W 27TH ST STE 1
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7207
Practice Address - Country:US
Practice Address - Phone:928-344-8400
Practice Address - Fax:928-344-8412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36740207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty